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1 1...�\I\11 1 r1� � ��V!"� ■ �v�� <br />BUILDiNGIMEC�NICALIPLUMBING/SIGNI INKLER/DEMOL1TlON <br />CITY OF EVERETT PERMIT SE�ES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ITE ADDRESSs �, ,-� �_ , '' <br />� � � j 1 � 1 r�-' `� <br />ERTY TAX q PERMIT #! <br />s!��'4Z oo/�d vov � _ <br />�L for new construction: 5hort PlaUsubdivision Lot No.� (attach copy of tong legai description) <br />ER �i����� f101�.i//V ji fi�L/T/71J/Z Phone/E-mail / � .�L..S �7 , � Z � <br />ss�4�OX ��� CitylStat�p�J�/�E%J/lrvT� p Z�� <br />_ICANTt,� Owner _ Owner's Agent _ Contractor _ ConVactors Agent _ Tenant �musc Pro�taa e ienar or eonseni tr�m wa owner to do worx �, u,a sPe�� <br />TRACTOR /7N��/9� State_Lic. # �}�� ��1 �(7 q Z- City Bus. Lic. #l}�i� �,�f.° <br />ir��9n/D Y /�/E-'L T/i✓E` <br />L7�t7�d/ �/��"'� Phone/E-mail �.�� ��(��� ' ��� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK _ ��D O, � <br />Existing Use of Building J`r/�� <br />Proposed Use of Buiiding �/�/L ' Gas <br />Building type: _ Single Family _ Duplex Townhouse _ Multi-Family _ Commercial <br />T e of ro'ect: New Additfon Remodel Re air T.I. Si r1 S rinkler [ <br />DESCRIPTION OF WORK (additiona! space provided on the back): <br />Y " I.���r� ��+�'��� <br />� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn /� Alterz <br />Show Number (#) of flxtures <br />A/C — air handlin� <br />Forced air syster <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryei <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />►n ..._�•I� <br />_Repair <br />units <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />HEAT <br />Other <br />of Use <br />PLUMBtNG PERMIT APPLICATION <br />of Project: _New _Addn _Alteratton _Repalr <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barlmop/etc.) <br />BackBow preventer (inside bic <br />Urinal <br />Drinkinq Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other. <br />Other: <br />I hereby certify that I have read and axamined thls applicatlon and know the same to be trve and correct. Ali provisions of laws and ordfnances goveming thls type of work will be cor <br />wfth whether specffied hereip r not, The granting of a pertnit does not presume to give authortty to violate or cancel the provislon of any other state or local law reguladng constructl <br />That I am authortzed by th� o er o( this perty to peAorm the work forwhich applica8on Is made and I wmpy with'the State Contractors Law 18.27 RCW and 298.200A WAC. <br />/ <br />'. - C �,... �: � / 5 <br />OwnerlAuthorized Agent 5lgnature Date (Revised 4/2015) <br />